Certified addiction advocate, coach and consultant, Lesa uses lived experience and education to promote addiction awareness and prevention.
Video Game Addiction - A Destructive Disorder on the Rise
The purpose of this article is to help readers understand video game addiction, the signs and symptoms, impacts, and pathways to get help, in an easy to comprehend manner. The goal is that those who read this article will have a better understanding of gaming addiction, how and why it happens, and who it happens to.
In my line of work, I have seen a rise in the number of people, particularly tweens, teens, and twenties, whose lives are negatively impacted by compulsive gaming. Last year, I had the unique opportunity to develop and deliver a day-long training on technology addiction to state employees in 10 different regions of New York. A topic in that training was dedicated to video game addiction. My experience in researching and teaching about gaming addictions, and working with individuals and families that are impacted, has shown me that there are misunderstandings and misconceptions that plague talking about, and effectively addressing it.
Defining Video Game Addiction
Gaming addiction is described as an “impulse control disorder” which does not involve the use of an intoxicating drug, chemical, or substance. Gaming addiction has also been referred to as video game overuse, pathological, compulsive, or excessive use of computer and/or video games. Video game addiction has not always been recognized as a mental health disorder, but recently has received the classification. In the 11th International Classification of Diseases, the World Health Organization (WHO), includes "gaming disorder" in its list of mental health conditions for 2018, meaning obsessive gaming can now result in a mental health diagnosis.
To better understand gaming addictions, it's important to understand the power of the screen, and what goes on in it. It is not new information that activities involving engagement and interaction with a screen can become habit-forming or addicting. When the television first made its appearance, it wasn't long before research showed that prolonged television watching for children and adults could have negative impacts, and become an obsessive activity outside of one's awareness. Another example is casino video slot games, a type of gambling that has shown to be one of the more addicting forms of gambling, with video poker being recognized as the "heroin" of gambling addiction. Other activities that fall under the category of technology addiction are obsessive texting and sexting, social media, digital multitasking, excessive smartphone use, online shopping, gambling, pornography, and cybersex. All of these activities involve engagement with or a fixation on what's happening on the screen, and all of these activities can be habit-forming and problematic.
Effecting Youth through Young Adults
Understanding the Gaming Addiction Concept
It is well understood that many people can engage in using addicting substances and activities without developing problems or addictions because of it. Many can drink, drug, game, and gamble responsibly for example. Today, most people understand and accept the addiction concept when it comes to drugs and alcohol, but many are slow to accepting activity or process addictions, such as video gaming. It is estimated that 8.5 percent of Americans between the ages of 8 and 18 are addicted to video games, that's 1 in 10 youth.
In the industry, we use the word "narcotic effect"; a feeling, or physical, emotional, or mental reaction similar to the effects of drugs and alcohol. Like drugs and alcohol, certain activities like video gaming and video gambling, stimulate the areas of the brain responsible for pleasure, escape, reward, acceptance, and relief. For some, even though there are no drugs ingested, the effects of engaging in the activity are narcotic, often including mood alteration, physical and emotional pain relief, dulling of the senses, a feeling of "being out of it", distraction, and not having to think, feel, or care. One does not have to ingest drugs or alcohol to experience a narcotic effect. A new brain scan study shows Internet addiction, to include online gaming, might cause the same brain changes that are seen in alcoholics and drug addicts. Understanding this, we can better comprehend why some people aggressively return to, and abuse addictive activities like gaming over and over again. Like with drugs and alcohol, those addicted to gaming, like the way it makes them feel, it's intoxicating.
When gaming, pleasure chemicals are released in the brain (dopamine) and some individuals, based on biological, genetic, environmental, and emotional factors, latch onto this and feel an uncontrollable need to obsessively return to gaming to continue experiencing its effect. The use intensifies as tolerance develops, and more time is spent engaging in gaming to get the desired feeling. One is unable to “pull away” regardless of mounting negative consequences that often include; emotional, financial, mental, personal, school, or career.
Virtual Reality More Stimulating Than Reality
Simple video gaming for some is problematic enough, but the days of Atari and Nintendo, Donkey Kong, and Pac Man are long gone. The gaming experience is more real life than ever. Technology advancements, the convenience of the internet, and increases in gaming equipment quality has created a powerful opportunity to get high and escape for many who abuse it. There are numerous factors that lead to addiction, but one particular to note regarding gaming addiction is environmental. One key reason video games can be highly addictive is that they are designed to be that way. The video game industry is a multi-billion dollar business, and like anyone else trying to make a profit, are always looking for ways to generate more customers, and keep the ones they have. The Global Games Market Report shows that in 2017 gaming generated $108.9 billion in revenues. Video game designers, design games that draw people in and stimulate areas of the brain responsible for pleasure and reward. Like video gambling slot machines, every dynamic of the machine and game experience is created with enough risk, challenge, and reward to keep you coming back for more, but not so challenging or risky that a player would give up; because what would be the point of that for video game or machine designers, whose profits are in direct proportion to the money and time invested from their repeat customers. In other words, success for a gamer often feels just out of reach, just as winning does for the gambler. In this respect, video game addiction is very similar to the more widely understood gambling addiction.
Because of gaming sophistication, users can escape in a virtual world that seems more real than ever. Those who abuse, or develop problems because of it, often feel that their virtual world is more interesting, stimulating, comforting, and accepting than their real world. Not to mention the element of power, control, and confidence that many say they have in their virtual worlds, that they don't have in their real worlds. This concept holds true for most who develop internet use disorders or tech addictions. Many people are becoming more connected, involved, and interested in what's happening in their virtual lives or on the screen, than their real lives. If not careful, one could develop a false sense of restoration, revitalization, and stimulation that is narcotic and intoxicating, which can lead to problems or addiction outside of one's awareness or control.
I like to refer to the categories of gamers in the same manner as I refer to them in gamblers. There are many platforms and types of video games, just as there are many forms and types of gambling, but when it comes to categories of the gamer, there are four unique to this activity.
Professional gamers are the rarest form of gamers and depend on games of skills rather than luck to make money. They have full control over the time, money and energy they spend on gaming, and do not exhibit signs of problematic use or addiction. Professional gamers are able to responsibly game as a career.
Social gamers consider gaming to be a valid form of recreational activity, entertainment, and fun. Social gamers maintain full control over the time, energy, and money they expend on gaming and do not exhibit signs or problematic use. Social gamers could take or leave the gaming experience and usually engage with friends or others who are socially gaming also. Social gamers consider the time spent gaming, or the cost, if there is one, to be paid for the entertainment only. Many problem gamers or addicted gamers consider themselves social gamers while in the denial phase of their addiction.
Problem gaming involves the continued involvement in gaming activities, despite the development of negative consequences, loss of time, and interest in other activities. Not all problem gamers have a gaming addiction, but problem gaming often leads to gaming addiction if not addressed. It's difficult to break this cycle at this stage because gamers do not believe they are developing a problem. They believe, like all who develop addictions, that they can stop whenever they want to. Furthermore, most gamers do not even recognize that video gaming is addicting, so trying to set limits is not something they are interested in doing or feel is important.
When gaming activities intensify regardless of consequences, the need to continue to game rises despite the desire to stop, control, or cut back, and anger, anxiety, or depression flare when unable to game, addiction has set in. Those addicted to gaming will continue to do what is necessary to game despite dangerous emotional, physical, relationship, and sometimes, financial strain. Gaming addiction, like gambling addiction, can progress, with control completely lost. When gaming reaches the addiction state, professional help is usually needed.
Two Types of Compulsive Gamers
The Compulsive Action Gamer
The compulsive action gamer, games for action, risk, rush, adventure, and adrenaline. This type of gamer is stimulated by the "action" effect and compulsively engages in action games to continue to achieve this effect. Action gamers usually play games that involve gun fights, car crashes, enemy destruction, or sport/personal challenges. They typically are interested in playing the hero or villain. Action gamers prefer first-person shooter video game genres (FPS) which are centered around guns and other weapon-based combat in a first-person perspective; that is, the player experiences the action through the eyes of the leading character. Action gamers often game with others in the real and/or virtual worlds and are stimulated by the presence of others, often competing or playing with a competitive edge, playing games of skill than of luck.
Some Game for Action
The Compulsive Escape Gamer
The compulsive escape gamer often games to escape problems, cope with bad feelings, and get relief from controlling factors experienced outside of gaming. This type of compulsive gamer is addicted to the numbing and hypnotic effects they experience from gaming. This is not to say that escape gamers do not play action games, but they are typically more drawn to games of luck than of skill, prefer to game alone, and often play victim or third person shooter games (TPS) which is when the player can see (usually from behind) the character they are controlling. Other game categories escape gamers play involve role-playing, simulation, fantasy, and strategy.
Regardless of gamer type, most gamers who develop problems enjoy either creating and becoming an online character, completing a mission, or beating an online score. Most like to build a relationship with other online players and/or escape from reality into the virtual world. For some, this community may be the place where they feel they’re the most accepted.
Some Game for Escape
Signs of Video Game Addiction
Though this disorder can have significant consequences to those suffering from it, its signs and symptoms can sometimes be very difficult to recognize. Some of the signs are similar to the signs of drug or alcohol addiction, and many similar to the signs of gambling addiction. As with any other addictions, it is important to know how to recognize these signs if you or someone you care about is an avid gamer. Research suggests that symptoms can be both emotional and physical.
- Feelings of restlessness and/or irritability when unable to play
- Avoiding sleeping or eating to continue gaming
- Preoccupation with thoughts of previous online activity or anticipation of the next online session
- Lying to friends or family members regarding the amount of time spent playing
- Isolation from others in order to spend more time gaming
- Absent from family and school events or responsibilities in order to game
- Downplaying or minimizing computer or internet use
- Lack of control (setting limits cannot stick to)
- Loss of time
- Negative impact on other areas of life
- Migraines due to intense concentration or eye strain
- Carpal tunnel syndrome caused by the overuse of a controller or computer mouse
- Poor personal hygiene
- Hiding from negative or uncomfortable feelings or situations
- Misuse of money (constant upgrades, gaming-related items, hardware, etc.)
- Mixed feelings and emotions (guilt, euphoria, depression, confusion) because of intense gaming
- Virtual living vs. reality living
E-Toxing (Gaming Addiction Withdrawal)
E-toxing is a term used in a similar manner as detoxing for substance abuse. Just as those who deal with drug and alcohol addictions experience withdrawal symptoms from substances, those with technology or internet use disorders experience withdrawal symptoms from devices. Withdrawal from devices can be moderate to severe, and some symptoms are similar to withdrawal symptoms from drugs or alcohol. It's important to understand that e-toxing is real, and if a gamer is unable to game, or is trying to cut back as part of a plan, any of the withdrawal symptoms could flare. Like with drugs and alcohol, withdrawal is a trigger to use. Addicted substance abusers know that the only means of making the withdrawal symptoms go away, is to drink or drug. If the addicted gamer is experiencing withdrawal symptoms, he or she also knows that the only way to make the symptoms go away, is to game. Getting through withdrawal is an important hurdle to jump for anyone dealing with addiction.
- Anxiety and depression
- Loss of sleep
- Severe restlessness
- Body aches (head, stomach, back) most common
- Loss of hair
- Nutrition issues (increase intake using food as a replacement, loss of appetite)
- Mental and physical distress
- Severe cravings
- Mood swings
- Loss of interest in activities outside of internet or device
- Feelings of hopelessness
- Loss of interest in living (suicidal ideations)
Help is Limited, But Increasing
If you, or someone in your life is an avid gamer, or you suspect problem or addiction, you may not find a lot of resources on getting help specifically for video game addiction, however; help is available. Counseling or coaching has proven effective, and there are also self-help groups on and offline. For those who qualify and seek a higher level of care, out-patient or residential treatment for gambling addiction or internet use disorders are available.
Because many gamers that have developed problems are minors, it is difficult for parents to know what to do. Admitting your minor child to a treatment program for gaming addiction is likely not an option, even if the option were there. Many loved ones, parents, spouses, etc., are angry or frustrated with the addicted gamers in their lives regardless of their age, and many feel hopeless. Putting limits on gaming is an excellent preventative strategy for parents, but often parents don't try to do this until it is too late.
Most parents only intervene when they recognize that a problem exists. Unfortunately, because parents don't identify with the addiction concept, they place limits with the expectation that their gamer will honor. If addiction has already set in, setting limits is difficult, if not impossible for a gamer to honor. With this, conflict often flares between the gamer and family, as the gamer will lie and manipulate their time to try to hide their gaming. It's important for mom's and dad's to understand that if they set gaming limits for their child gamer, and the child cannot stick to those limits, a serious problem already exists; frustration, punishment, and anger is typically not going to solve it.
Like a drug addict needs their drug to avoid withdrawal symptoms, the addicted gamer needs to game to avoid the same; you may be lied to and disrespected until the situation becomes manageable for the gamer. If you have a gamer in your life regardless of age, and you suspect a problem, you may want to seek professional help. If your son or daughter is impacted, consult with their primary health professional to determine if there are other medical issues that may be contributing to obsessive gaming, such as depression, anxiety, ADHD, etc. May I also suggest the following non-clinical strategies that I use in my coaching practice:
- After you fully educate yourself, talk to your gamer on a mature level, regardless of their age. Let them know your concerns, and help educate them on video game addiction. Show them articles, and go over the signs and symptoms with them, pointing out the ones you see they are experiencing. Approach this gently and with a loving and caring nature. Let them know they are not alone and that this issue is impacting a lot of kids and young adults. Education and compassion are powerful when first having the conversation.
- Help establish a plan, not just your idea of what they should do, but allow them to have full participation in their plan. Let them know that the plan does not have to be about completely stopping all gaming activity (keep in mind that if the gamer is experiencing severe addiction and dependency issues, and you try to make them stop completely, it's like asking them to take their last breath) gradual is sometimes a more acceptable approach to the gamer, and if you can make the plan "game like", it is often an effective strategy. As parents, be firm in the plan and the accountability, but understand there may be setbacks. The plan should include agreed-upon limits for gaming, and also a plan to get the gamer back to the areas of life that have been avoided because of gaming, such as hygiene, nutrition, friends, school, sleep, etc. Create a chart of the plan and have the gamer be responsible for filling it out.
- Celebrate even the smallest of accomplishments with the plan. Be supportive and encouraging, and be sure to point out the strengths and strong qualities of the gamer. The goal is to get the gamer to re-connect with the real world. Positive feedback, encouragement, and statements that help boost confidence from "real" people will help establish connectedness back with reality and show the gamer that they don't have to rely on such from a "fake" world.
Awareness is the Means to Prevention
Gaming Addiction More Widely Understood
With addictions typically associated with the abuse of substances such as drugs and alcohol, it is now becoming more widely understood that compulsive behaviors, which can include obsessive gaming, are also considered to be addictions. In the medical world, in order to be considered an addict, the person must have built a strong dependence on a substance or behavior, where the failure to participate in it results in anger, anxiety, irritability, and unhappiness. Whenever addicted gamers are deprived of their chance to play, they are likely to exhibit anger, violence, depression, and other serious behavior or withdrawal symptoms. Fortunately, strong awareness campaigns have been launched, more research is being conducted, and better help options are developing for video game and tech addictions. Gaming addictions are serious disorders with serious negative consequences; like gambling addictions, they can progress in nature if not addressed.
Your Feedback is Important
This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.